我们能否从弥漫性大B细胞淋巴瘤的基线F-FDG PET/CT成像中的健康组织摄取和体积获得预后信息？
Can we obtain prognostic information from healthy tissue uptake and volume in baseline F-FDG PET/CT imaging in diffuse large B-cell lymphoma?
作者信息
Gerards Nienke R, Wiegers Sanne E, Bes Anne L, Eertink Jakoba J, Lugtenburg Pieternella J, Zijlstra Josée M, Boellaard Ronald, Zwezerijnen Gerben J C
机构信息
Department of Radiology and Nuclear Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands.
出版信息
Eur J Nucl Med Mol Imaging. 2025 Aug 18. doi: 10.1007/s00259-025-07503-9.
PURPOSE
Diffuse large B-cell lymphoma (DLBCL) patients often experience relapse or progression after treatment, emphasizing the need for better prognostic markers. This study investigated baseline FDG uptake and volume of healthy tissues and tumours, to assess their association with time-to-progression (TTP) in DLBCL.
METHODS
This study included 259 newly diagnosed DLBCL patients. Outcome was two-year TTP after treatment initiation. Automatic segmentation of tissues was performed on the low dose CT scans. Tumour lesions were outlined with a semi-automated segmentation method (standardised uptake value ≥ 4) and subtracted from the tissues. Mean standardised uptake value (SUVmean), tissue-to-blood SUVmean ratio, volume, and total lesion glycolysis (TLG) were determined for the spleen, liver, kidneys, lungs, and brain. Only SUVmean and SUVmean ratio were assessed for fat, bone, and skeletal muscle. Intercorrelations among all tissues and correlations with tumour TLG were calculated. Volume and uptake measures were compared between patients with and without progression using the Wilcoxon signed-rank test. Any measure significantly associated with two-year TTP was added to an existing logistic regression model based on baseline tumour characteristics to assess its added prognostic value.
RESULTS
Patients with progression showed a significantly higher spleen-to-blood SUVmean ratio, lower SUVmean and TLG in the brain, lower SUVmean in skeletal muscle, and a larger liver volume. Liver volume and spleen-to-blood SUVmean ratio did not significantly improve the prediction of two-year TTP compared to the original model only based on tumour characteristics.
CONCLUSION
Healthy tissue PET/CT measures were significantly associated with two-year TTP in DLBCL patients. However, these measures did not improve the prediction of two-year TTP compared to models using only tumour characteristics.
TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION
HOVON-84: EudraCT: 2006-005, 174 - 42, retrospectively registered 01-08-2008.
目的
弥漫性大B细胞淋巴瘤（DLBCL）患者在治疗后常出现复发或病情进展，这凸显了对更好的预后标志物的需求。本研究调查了健康组织和肿瘤的基线氟脱氧葡萄糖（FDG）摄取及体积，以评估它们与DLBCL患者疾病进展时间（TTP）的关联。
方法
本研究纳入了259例新诊断的DLBCL患者。观察指标为治疗开始后的两年TTP。对低剂量CT扫描进行组织自动分割。采用半自动分割方法勾勒出肿瘤病变（标准化摄取值≥4），并从组织中减去。测定脾脏、肝脏、肾脏、肺和脑的平均标准化摄取值（SUVmean）、组织与血液的SUVmean比值、体积以及总病变糖酵解（TLG）。仅对脂肪、骨骼和骨骼肌评估SUVmean和SUVmean比值。计算所有组织之间的相互相关性以及与肿瘤TLG的相关性。使用Wilcoxon符号秩检验比较有进展和无进展患者之间的体积和摄取测量值。将任何与两年TTP显著相关的测量值添加到基于基线肿瘤特征的现有逻辑回归模型中，以评估其额外的预后价值。
结果
病情进展的患者脾脏与血液的SUVmean比值显著更高，脑内SUVmean和TLG更低，骨骼肌内SUVmean更低，肝脏体积更大。与仅基于肿瘤特征的原始模型相比，肝脏体积和脾脏与血液的SUVmean比值并未显著改善对两年TTP的预测。
结论
健康组织PET/CT测量值与DLBCL患者的两年TTP显著相关。然而，与仅使用肿瘤特征的模型相比，这些测量值并未改善对两年TTP的预测。
试验注册号及注册日期
HOVON - 84：欧洲临床试验数据库（EudraCT）：2006 - 005，174 - 42，2008年8月1日追溯注册。
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